VA ILP CODICIL DISCOVERED

Posted on November 7, 2013 by asknod

imagesAll this time I thought I was being discriminated against with the VA denying my request for a greenhouse. Member Bruce (Tip of the ILP Spear) in Georgia sends us this by way of explanation. It’s all been a huge misunderstanding on my part all this time. Remember kids-semantics is king at the VA. Always read the fine print and you’ll find why you were denied. 

VA is adroit at camouflaging their programs such that you can apply until you are blue in the face. This doesn’t change anything and, in fact, they often have the audacity to tell you not to give up and come back later for another dental rearrangement in the future. Given enough Valium, we can be taught to smile while we recite by rote “Please, sir. May I have another denial?”

Hidden way back on page 16, is the giveaway carefully inserted to be as innocuous as possible:

The Independent Living program is to make sure that each eligible veteran is able, to the maximum extent possible, to live independently and participate in family and community life increasing their potential to return to work. Services may include the following:

  • Assistive technology

  • Specialized medical, health, and / or rehabilitation services

  • Services to address any personal and / or family adjustment issues

  • Independent living skills training

  • Connection with community-based support services

Eligibility Requirements

Veteran’s whose service-connected disabilities are so severe they are currently unable to purse an employment goal.

 

Now parse the wording of 38 USC § 3120 (e) (1):

(e)

(1) Programs of independent living services and assistance shall be initiated for no more than 2,700 veterans in each fiscal year, and the first priority in the provision of such programs shall be afforded to veterans for whom the reasonable feasibility of achieving a vocational goal is precluded solely as a result of a service-connected disability. 

Turning to Miriam Webster’s Essential VA translator:

pre·clude

transitive verb \pri-ˈklüd\

: to make (something) impossible : to prevent (something) from happening

: to prevent (someone) from doing something

  Seems there is some disagreement on what ILP is and is not. My enlightened Vocational Rehabilitation Parole Officer insists it means that if you aren’t going back to work, you get can grabbers for the top shelf, thingamajiggies to pull your socks up with, a cordless phone to use as a device when you fall down and are having trouble getting back up and the like.

Now, let’s see how the Tip of the Spear krewe do it back in Georgia. Bruce insists this is a “small” version of the Texas-size greenhouse. He didn’t want to appear greedy.

100_0845100_0683100_0682

 

Seems VA is fumigating my anal sphincter. If you recall, VA was calling these greenhouses back in March of this year and insisting I had more than I knew what to do with:

greenhouse 4 RO 001

greenhouse 4 RO 002

 

For the record, VA insists these are my four greenhouses. If I paint my house green, I’ll have five.

images (1)

VA ILP-approved greenhouse

Posted in Independent Living Program, VR&E | Tagged , , , , , , , , , | 2 Comments

VA’S OIG MONTHLY MISHAP REPORT OUT

Posted on November 7, 2013 by asknod

Investigate nowAs usual, misbehaving VA patients locked up in the Psyche ward are doing everything in their power to screw up bonus checks for the Lyons, New Jersey, VA Medical Center’s head honcho.  In a deliberate attempt to sandbag his chance  at a $10,000 ” VISN Dude of the Year” award,  an unidentified inmate inpatient purposefully consumed his prescribed medications instead of refusing to. Get a load of this bag of Halloween candy. No wonder he came down with a fatal tummyache. Relax. VA’s OIG is on it like whitewash on rice.

The Office of the State of New Jersey Medical Examiner’s autopsy report listed “Acute intoxication due to the combined effects of cyclobenzaprine, tramadol, gabapentin, sertraline, hydroxyzine, and amlodipine” as the cause of death. The manner of death (suicide, homicide, accidental) was listed as “undetermined” and final diagnoses included hypertensive and atherosclerotic cardiovascular disease. 

Man, that hypertension thing is a killer. Beware. That was just the lead-in article. Here’s another one of those “If the Veteran had just told us where the owie was, we wouldn’t be talking about this now”…

OIG found factors that contributed to the missed diagnosis as well as opportunities for improvement in system processes that affected this patient’s care. The oversight of the patient’s care continuum was lacking, and there was inadequate communication between primary and specialty care providers and VA and community health care facilities. OIG recommended that the Network Director initiate a root cause analysis to evaluate system issues outlined in this report and evaluate the care of the patient discussed in this report with Regional Counsel for possible disclosure to the surviving family member(s) of the patient. 

Bummer, dude. The patient’s care “continuum”was lacking. God, I hate that when that happens to me. There went the Grand Poohbah’s bonus check. Might be time for a root canal of the individuals involved rather than a root cause analysis. The Vet is dead. Helloooooo? How is discussing the screw-up post-mortem with the family going to do ameliorate anything? Maybe talk them out of filing that SF 95?

download1Another positively delicious item. Remember the Orlando Human Resources  All expenses paid Golf Tournament and Karaoke Training Conferences as in plural? The final tally on that extravaganza  is coming home to roost ($15.5 million-over two years) but as with any OIG investigation, this one has been expertly alphabetized to mask ownership. Thus you get (variously) IA (interagency), OPM (Office of Personnel Management), SPI (Separately Priced Item) and OALC (no one ID’d that one). OIG’s unofficial motto is “If we can’t impress them with our intelligence, we baffle them with our bullshit.”  An example:

OIG recommended the Assistant Secretary for Human Resources and Administration (AS/ HR&A) consider discontinuing the use of assisted acquisition IAs with OPM for training conferences and establish controls to improve oversight of SPIs purchased through existing assisted acquisition IAs with OPM.

We took this to an expert at VA  who wished to remain nameless and had him translate it into Vetspeak. Here’s the Hooked on Phonics® version:

download (1)The Office of Intercepting Goofups at VA informed the number two guy over at Human Resources that he was in deep ship if they kept putting Karaoke training, ice sculptures, complimentary 18-round golf, helicopter tours and wine tastings on the official VA tab. Henceforth, they must be buried deeper so accountants cannot excavate them as easily. It was suggested that they hide it in the Information Technology budget which has a secret slush fund specifically created  for this contingency.

September’s VA follies can be viewed in all their shining splendor here. The ones cited above were just the low-hanging fruit.

VACO Human Resources Water Coolers

VACO Human Resources Water Coolers

Posted in OIG Entertainment | Tagged , , , , , , , , , , | 1 Comment

STARBUCKS® TO HIRE 10,000 VETS

Posted on November 6, 2013 by asknod

images (1)Maple member of Vermont Frank sends us this news regarding Starbucks® which certainly bodes well for Vets. The military turns you into a killing machine so it stands to reason you should be adept at creating killer coffee, right? 

At any rate, this certainly bodes well for many newly minted Vets who are wondering where their future lies. The new employment paradigm these days seems to be less jobs with less full-time employment in a concerted effort to avoid having to pay for medical care under the new ACA. Fortunately, Starbucks has not followed suit and, in fact, moved in the opposite direction. Veterans could do far worse (read Mickey D’s) for a future with one company. Even if it is a stepping stone, no one looks down on a barista. They are an artist in their own right who works with a liquid medium as opposed to a canvas.  With all due respect to burger flippers, it’s hard to make an artistic statement with a Big Mac. Yours never look like the one in the picture there.

download

mine are vertically challenged compared to this.

As an added bonus, this offer extends to military spouses which will help dramatically on extended deployments. Income in the military is not exactly magnanimous so any extra is a welcome addition for these spouses (both male and female). A warm thank you to Starbucks personnel the next time you are there would be in order. What the hey? Ask them if they’re a Vet. As members of the 7% club, we should be inordinately proud of our contribution to America. Show that same appreciation next Monday if you find yourself there.

Posted in All about Veterans, Food for the soul | Tagged , , , , , , , , , | 7 Comments

VETERANS DAY DISCOUNTS

Posted on November 5, 2013 by asknod

downloadOne day a year America recognizes her Veterans on this side of the grass. Memorial Day is for the ones on the other side who have reached room temperature. Regardless, there is much hoopla. Veterans are getting to be big business. Soon someone will come along (probably from the DAV) and “brand” his or her product Veteran and it will become inviolate. We will no longer be allowed to use the term ourselves without paying royalties to the owner. The VA, much like the NFL, will license the VA Seal and the For he who shall have borne the Battle to the highest bidder. Large Insurance companies will seek to obtain the name and incorporate it into their Corporate Logo. I mean it figures this will be next. With Congress forbidding any bonuses to VA employees, there will simply have to be some quid pro quo. Tanqueray is not cheap regardless of what they tell you in Sioux Falls. 

As an aside, I would point to the picture above. It’s on the right next to the highway after you pass the front gate of Ft. Myer on your way into DC. I lived there off and on most of my life before I joined and I can’t count how many Cub Scout field trips that included this. It’s very impressive close up for 8 year olds. It exudes well, Victory with a capital V.  There are many monuments to the military but the Iwo Jima flag raising was an epic moment. And, much like the sporadic arrival of MIA remains at Wheeler AFB in Honolulu where they tow the derelict C-17 out of the hanger with the bagged and tagged guys on board, it must be re-enacted for the cameras. That does not detract for a moment from the historical significance but it seems rather hokey to have to recreate history.

download (1)Can you imagine if they had photography on Christmas Eve of 1776? “Whoa there, Gen. Washington. Could you extend your sword in your hand and point toward Trenton one more time? My flash didn’t go off.”  Imagine if they’d asked Gen. MacArthur to reboard the LST and come ashore again to “get the sun just right” over his left shoulder. Christ. He’d have to change his pants because they were wet up to the knees. It just isn’t the same. History has a caché that cannot be orchestrated. It is chaos by its very nature.

Fortunately, that’s all behind us as Veterans and we get our one square down at Applebee’s on Monday so we have that going for us. Member John has also equipped us with a list of go-tos and find the bargains that are available to us Monday. Start planning your field trips, Cub Sprouts.

Here’s the freebies  Veterans Freebies 2013

Here’s the discounts  Discounts

And we here at Ask Nod heartfeltly would like to thank each and every one of you who served for your sometimes thankless jobs and your devotion to America. Just as we cannot reconstruct the past (even though the VA often does), nor can we turn the clock back and get our tickertape parades when we came home from SEA, we also cannot forget that we would have indubitably done it all over again in a heartbeat-even if we knew the eventual outcome and consequences today.

Posted in All about Veterans, Food for thought, vA news | Tagged , , , , , , , , | Leave a comment

“Veterans Affairs Research Supports CDC Recommendation to Screen Baby Boomers for Hepatitis C”

Posted on November 5, 2013 by Laura

The families of the estimated
51,000 infected veterans not diagnosed yet are in for 
 a rough ride.

The “Liver Meeting 2013” conference in DC ends tomorrow. The sponsor of the meeting, the American Association of the Study of Liver Diseases(AASLD), released a press release (11/3/13) on the research of Lisa Backus, M.D., Ph.d. from the VA. As the excerpt below states, the VA believes that 51,000 veterans have yet to be diagnosed with HCV. That’s a massive number.

Researchers at the Department of Veterans Affairs (VA) studied the health records of 5,500,392 veterans. Of those, 64.2 percent of baby boomers and 54.7 percent overall — or more than 2.9 million — had at least one VA screening for HCV. Of those screened, 9.9 percent of the baby boomers had HCV infection, compared with 1.7 percent of those born before 1945 and 1.1 percent of those born after 1965.

After extrapolating the infection data to the veterans not yet screened, researchers concluded that up to 51,000 more veterans of the baby boomer generation could be identified with HCV. The VA has been a leader in adopting new care models such as telehealth and Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN ECHO) in order to expand the VA capacity to take care of any additional veterans identified as having HCV infection through expanded screening.

The story was picked up today by AIDSMAP.  Although the accusation that thousands upon thousands of Vietnam-era veterans injected drugs continues to be repeated ad nauseam in the media, at least the AIDSMAP article mentions jet injectors (air guns) in the 2nd paragraph of this excerpt.

US military veterans of the baby-boom generation form a population at higher-than-average risk of hepatitis C. Hepatitis C prevalence is higher in adults born between 1945 and 1965 due to higher levels of injecting drug use and greater lifetime risk of exposure to blood transfusions containing hepatitis C compared to those born after 1965.

Veterans may be at especially high risk of hepatitis C infection due to high levels of injecting drug use among the population that served during the Vietnam War era and blood exposure in battle or medical settings. Tattooing and transmission through use of airguns for vaccination during military service are difficult to quantify as sources of infection, but many veterans – particularly those who did not see active service in Vietnam – believe these routes explain their infection with hepatitis C.

vietnam-soldiers-crater

Soldiers at the bottom of Hamburger Hill (Hill 937) in Vietnam 10-20 May 1969

Keith Alcorn’s article, Need for expansion of hepatitis C screening among veterans, ‘baby-boom’ generation and pregnant women highlighted, is welcome.  But repeating the IVDU canard is not. Accusation is not evidence. It’s a diversionary tactic to “explain” away the cluster of service-connected HCV infections.   Vietnam veterans were fulfilling their missions and trying to staying alive.  A shocking 58,286 died doing America’s hardest job–the work of war.  The Vietnam Veterans Memorial Foundation NJ) reminds us that many more have died as the result of the war from HCV, AO, emotional and physical injuries.  To accuse hundreds of thousands of veterans of spending their few hours of rest, giddily injecting drugs, is a grave insult to this much maligned group of heroes. 

Ed. note: An interesting side note is the plethora of draftees who were pulled into this against their will. Certainly, some of these were unsavory characters who may have engaged in the practice of IVDU but their presence in a shot line using a pneumatic air injection device is all it would take to propagate the hepatitis C virus. No study of troops based on a subset of basic training has ever been accomplished nor will it ever occur.

Having been to VA medical centers, I can tell you first hand the queer looks I get when I mention my HCV. Reiterating the history of the infection via a transfusion for a GSW is greeted with the rolling of the eyeballs. I no longer try to set the record straight. Of course, I no longer go to the VAMC anymore either so it is a moot point.

Posted in Guest authors, HCV Health, HCV Risks (documented) | Tagged , , , , , , , , , , , , , , , , , | 4 Comments

Hepatitis C replication increased during pregnancy according to recent study

Posted on November 3, 2013 by Laura

 An abstract of a study just published in Nature signals  

pregthat mainstream medical associations, like the American Congress of Obstetricians and Gynecologists (ACOG), should become proactive by screening for HCV routinely rather than by known risk-factors. 

“Loss of immune escape mutations during persistent HCV infection in pregnancy enhances replication of vertically transmitted viruses” 

A few quotes from the abstract:

  • Globally, about 1% of pregnant women are persistently infected with the hepatitis C virus (HCV). Mother-to-child transmission of HCV occurs in 3–5% of pregnancies and accounts for most new childhood infections

  • HCV-specific CD8+ cytotoxic T lymphocytes (CTLs) are vital in the clearance of acute HCV infections, but in the 60–80% of infections that persist, these cells become functionally exhausted or select for mutant viruses that escape T cell recognition

  •  Importantly, the viruses transmitted perinatally were those with enhanced fitness due to reversion of escape mutations. Our findings indicate that the immunoregulatory changes of pregnancy reduce CTL selective pressure on HCV class I epitopes, thereby facilitating vertical transmission of viruses with optimized replicative fitness.

Medical societies know that HCV is contagious, serious, and can be passed on from mother-to-baby.  But pregnant women are only screened routinely for hepatitis B.  If they are HIV-positive, HCV screening is ordered.  But the current risk factor based screening is a flawed concept.  That HCV infects babies is a terrible reality. Screening is easy and fast with the OraQuick HCV test.

The VA could take a national leadership role in this area due to changing veteran demographics:

Women are now the fasting growing subgroup of U.S. Veterans. The number of women Veterans is expected to increase dramatically in the next 10 years, and VA health care is expected to be in high demand by the women Veterans of Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn.

baby va

Please test my mom
for HCV

Specialty care for women includes these conditions and much more: 

  • Management and screening of chronic conditions includes heart disease, diabetes, cancer, glandular disorders, osteoporosis, and fibromyalgia as well as sexually transmitted diseases such as HIV/AIDS and hepatitis.
  • Reproductive health care includes maternity care, infertility evaluation and limited treatment; sexual problems, tubal ligation, urinary incontinence, and others.

 Let VA help–yes, please do. 

Update: Link to a lay article discussing the 

Nature article in plain language. 

Posted in Guest authors, HCV Health | Tagged , , , , , , , , , , , , , , , , | Leave a comment

Apps for veterans (# 1): Twitter

Posted on November 3, 2013 by Laura
twitter-bird-white-on-blue

Tweet out

The VA is using Twitter. To follow their micro-posts, sign up for a free account.  (Check out ASKNOD’s Twitter feed too.)  Information on how to use Twitter is on the HELP page. 

Official VA Twitter accounts: Department: https://twitter.com/DeptVetAffairs (122+K followers)

Administration:

VBA:  https://twitter.com/VAVetBenefits (24+K followers)

VHA:  https://twitter.com/VeteransHealth (32+K) followers)

NCA:  https://twitter.com/VANatCemeteries (3+K)

Don’t read OIG feed
if you feel like this.

Many VA medical centers, programs, and staff, also have Twitter accounts.  If your blood pressure is under control, I recommend perusing VA Office of the Inspector General Twitter feed: https://twitter.com/VetAffairsOIG

A few non-VA sites: https://twitter.com/cdchep;

https://twitter.com/HepatitisCTrust;

https://twitter.com/Hep_Alliance; https://twitter.com/InjectionSafety.

Article: New York Times (10/23/13) Twitter Illiterate? Mastering the @BC’s

Intrigued? Read Twitter’s blog: https://blog.twitter.com/

The company will be going public soon so it will become an even bigger social media player.  Do you tweet? 

 

Posted in All about Veterans, Guest authors | Tagged , , , , , , , | Leave a comment

SOFOSBUVIR HITS 85% IN SVR24 TRIALS

Posted on November 2, 2013 by asknod

downloadNow we’re talking, ladies and gentlemen. When I entered this arena in 1995, less than 33% were achieving any kind of success and some relapsed years after. The pegylated Interferon (PegIntron) of the early to mid 2000s again only hit about 50%+ in repeated trials. Genotypes 2 and 3, which were always the ones most expected to achieve sustained Viral Response (SVR) have been coming out on the skinny end in 12 week trials that are Interferon-free. Enter the new, 24 week regimen.

The latest news with 24 week regimens shows an 85% SVR among Genotype 3 HCV sufferers with most exhibiting SVR by week 12. When I “volunteered” for Project 404 in July of 1970, I wasn’t allowed to ask many questions about the assignment until after I had acquiesced and signed on the line. No, this isn’t about Obamacare but it parallels it in some respects. One question I pointedly asked was what the casualty rate was. They mentioned 35-40%. Being 19 and incredibly optimistic, this young airman converted that into a chance of coming out unscathed at 60-65% which is what incredibly optimistic, testosterone-infused young servicemen tended to do in war.

I consider an 85% chance of conquering HCV to be incredibly good odds. Conversely, a 15% failure rate is almost immeasurable in the scheme of medical mishaps. This is, in the final instance, another Win or Die proposition so it is not up for debate. Left untreated, I die. I have an 85% chance of success if I press on. In my book, that’s  incredibly good odds compared to 45 years ago. Where do I sign up?

Posted in HCV Health | Tagged , , , , , , , , , , , , , , , , | 4 Comments

NEW WIDGET

Posted on November 1, 2013 by asknod
80927778

An Khe chopper revetments

Here’s a great addition to the widget bar above. Sent in by Tip of the Spear Bruce McCartney (4 tour combat medic 68-72). It will bring back that hot sticky air and pungent aroma of decaying vegetation. I think there’s a picture of dang near every airpatch in country and at least 40 I never went near in the far south. Camp Evans, Camp Bikini, they’re all there. Enjoy. 

80871924

Dak To Airpatch (Khontum)

Nape strike at Can Tho 1968

Nape strike at Can Tho 1968

Home of 7th Tactical Air Control Center (7th TACC) my boss

Home of 7th Tactical Air Control Center (7th TACC) my boss

USO Saigon

USO Saigon

 

Posted in From the footlocker, Vietnam War history | Tagged , , , , , , , , , | Leave a comment

DRV ANGLES FOR MORE MONEY FROM UNCLE SUGAR

Posted on November 1, 2013 by asknod

Chuck Hagel, John KerryHaving lived on the Indochinese Peninsula for several years off the grid during the Vietnamese Misunderstanding, I can safely say the following article link represents subtle bargaining at a high level. I had much occasion to barter on the local economy for foodstuffs and other “essentials” and was quite adept at it by the time I left. Milo Minderbinder had nothing on me. Who do you know who could convert a $12 bottle of Johnnie Walker Black into $52 in the blink of an eye? Or a whole case for that matter.  One thing I took away from this was the innate love of the orientals to haggle for the mere sake of haggling. The price was immaterial. Both sides knew that going in. For argument’s sake, the object had a street value that was non negotiable. For a roundeye like myself, it was axiomatic that I hold my own in one of these arguments or lose massive face if I paid the initial asking price. 

Similarly, the eight man delegation headed up by Senior Lieutenant General Nguyen Chi Vinh, set the price of four new excavations for our soldiers’ remains as their opening gambit. We, in turn, are expected to bid two no trump and so on around the table. The Democratic Republic of Vietnam ( DRV or formerly Hanoi Jane’s playground) is feeling a little troubled by all the neighbors looking for what Hitler referred to in WW II as lebensraum   . China and others in their neck of the woods are all expanding their economic horizons and find themselves cramped for room. Our former enemies now view us as their possible allies if a territorial squabble busts loose.

We are already spending vast quantities of bucks excavating and cleaning up our former bases and their associated POL dumps. POL stands for Petroleum, Oil and Lubricants-i.e. anything of or having to do with oil. It tends to really screw up shallow water tables as they are coming to find out back at Camp Pour Le Jeune Garçons Et Filles in North Carolina.

In addition, just having a Naval ship or two sitting at at anchor in the harbor at Cam Ranh Bay can express a thousand words to casual observers. And as assuredly as word travels at the speed of light, that information is telegraphed to the four corners of the East China Sea.

To the uninitiated, this may seem like a warm, fuzzy get together with noble aspirations down at Fort Fumble but it is nothing more than Asian posturing and bartering for an upper hand. I do hope Messieurs Kerry and Hagel are smart enough to recognize the signs and signals. I’d sure hate to see Americans refurbishing  and refortifying CRB and Vung Tau in a few years.

data=VLHX1wd2Cgu8wR6jwyh-km8JBWAkEzU4,wek-UW_atADNJV4i368PMeWd7QK2ftapweYIj6LLLML0DuMWJCvmPut-QS7gUPtrY88Wa_UDEq8RklZrX5v12UMfONrPsBYSan2OG4u0Nkr7uBYJXGy2TZxe-Di2gD0JAoTBt2MSFLvcRs_s-KQ0mONGDneTpYxn67fVZ_xoTh1gCCEQXwt5KFzB

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